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Savannah White

Mrs. Olsavsky

AP English Language & Composition

31 Jan. 2018

“Split Mind” Medication

Schizophrenia: a term coined from the Greek language translating to ‘split mind’.

Schizophrenia is not one disease, but rather a variety of disorders (APA). This psychological

illness prohibits the freedom of mind by impairing thoughts, feelings, and behaviors. The most

common treatment for this disorder is the use of antipsychotic drugs. These are psychiatric

medications that alter neurotransmitters in the brain to regulate chemical levels and alleviate

symptoms. While some psychology experts argue that antipsychotics have detrimental effects on

Schizophrenic patients, other psychologists are advocates for these drugs in maintaining their

proper health. Despite psychology expert criticism that antipsychotics pose health issues to

Schizophrenic patients, antipsychotics provide a safe way of deterring disruptive behaviour

and thoughts. First, antipsychotics provide a more consistent form of treatment for

Schizophrenia in comparison to the therapeutical approach. Second, antipsychotics improve a

variety of cognitive skills that can become impaired from the disorder itself. Finally, the

beneficial effects of antipsychotics outweigh the risks that come with refuting medication.

In 1950, a French pharmaceutical company synthesized the first antipsychotic,

Chlorpromazine, and discovered its medical benefits to be profound in the field of psychiatry.

As medical knowledge advances with time, dissent grows as well. Some psychologists believe

that non-pharmacological treatments are a better alternative to antipsychotics for Schizophrenia.

The most common type, cognitive-behavioral therapy (CBT), is a type of psychotherapy that
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encourages patients to focus on altering negative thinking patterns by facing the root of the

problem (Psychology Today). In a study review by The Lancet in 2014, psychologists tested the

effects of CBT on Schizophrenic patients and concluded that it had enough positive effects on

patients to be considered a safe, alternative method to antipsychotics (Morrison). Another

Professor of Clinical Psychology, Daniel Freeman, promoted the idea of CBT as a safer method

by stating “we may at last have a genuinely effective, relatively cheap, and side-effect-free

alternative to antipsychotics.” Although, with any form of treatment, there are going to be side-

effects, whether they be positive or negative. In a Science Mag review, CBT and antipsychotics

were compared on Schizophrenic people and psychologist Keith Laws believes there were no

real differences in outcomes (Laws). This suggests that antipsychotics do not provide enough

cognitive advantages in relation to therapy to be considered a primary treatment. The

psychologists who advocate for a therapeutical approach in treating Schizophrenia believe the

psychotic route does not give patients enough positive side effects to remain the first-line

treatment.

While a therapeutical method can benefit Schizophrenic patients who are taking

antipsychotics, therapy alone is not a viable method to treat Schizophrenia because it does not

effectively improve symptoms on its own. In 2014, Chief Executive of Rethink Mental Illness,

Paul Jenkins, voices his lack of support for CBT in Schizophrenia by claiming it is an

“invaluable tool for helping them manage their illness and improve their quality of life” (BBC).

Although CBT is not deemed as an invaluable method and has been known to aid in decreasing

symptoms, it should not be a primary and unaccompanied form of treatment. In another trial

review, Dr. Morrison’s study in support of CBT as an alternative concluded with an utterly

unanticipated statement that therapy is a “safe and acceptable method… not safe and effective.”
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His contradictory statement toward the study demonstrates a lack of efficacy. In another trial in

2012, psychologists examined the effects of cognitive behavioral therapy in Schizophrenic

patients and found a significant increase in negative symptoms after one year (Klingberg). The

non-pharmaceutical method of treatment does not have enough positive outcomes to become a

safe and effective alternative to antipsychotics.

Considering future safety risks and benefits, antipsychotics acquire better long term

outcomes in comparison to therapy alone. Psychologist Keith Laws supports this claim in a 2015

review that points out seventy-five percent of CBT studies show non-significant changes in

symptoms. He also includes a statistic that Schizophrenic patients who are “unmedicated are ten

times more likely to die” (Laws). With chances of fatality being this high in non-medicated

patients, therapeutical services alone can easily be deemed as an unsafe solitary alternative. Not

only has this method been verified ineffective alone, but it also increases negative symptoms

over time. In 2017, Alexander Rozental, PhD reviewed a psychotherapy study where “a third of

people had a difficult memory resurface, had more anxiety, or felt stressed” over the course of a

year (Science Daily). Psychotherapy is the broader spectrum term for therapy that includes CBT.

There are no claims in this study that indicate any use of antipsychotics, but there is an acute

focus on patients who experience a higher rate of adverse symptoms due to therapy. In another

breakthrough study, Professor Stefan Leucht reviewed Schizophrenic patients in 2011 who were

receiving placebo pills and antipsychotics; only twenty-seven percent relapsed on medication

and sixty-four percent on placebo relapsed in the length of a year (Allen). This data indicates the

crucial role that antipsychotics play in preventing relapses in Schizophrenics. Sharing a similar

perspective, Juan Gallego, MD, states “antipsychotics are needed, required, and we cannot treat
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schizophrenia without them" (Brooks). With regards to long term consequences, antipsychotics

are a much safer, effective route in comparison to the therapeutical method.

A common misconception of psychiatric drugs is that they can abnormally impact

cognition capabilities following excessive usage. In reality, research proves that these

medications prevent setbacks. Despite this revelation, psychology experts argue that

antipsychotics have a direct link to cognitive impairments in Schizophrenia. For instance, in

2013, a study reviewed by The American Journal of Psychiatry assessed the relationship between

antipsychotics and the intensity of cognitive impairments in Schizophrenic patients. These

impairments in the brain were linked to the drug (Sweeney). This study fails to suggest that

cognitive difficulties can derive from the disease itself, disregarding the medication. In another

trial in 2007, cognitive impairments in rodents were tested and data suggests that atypical and

typical antipsychotics have negative effects on cognitive skills through a deficit in memory

retainment (Terry). In trials such as these, there are a variety of variables not considered, such as

living environments or simply genetics that can skew the outcomes. Some experts even claim

that these drugs not only impact memory years after illness onset, but verbal fluency as well

(Husa). This statement is arduous to prove considering the disease alone contributes to negative

side effects including as verbal impairments. According to these studies, antipsychotics are

linked to a lack of cognition skills in Schizophrenia patients.

Contrasting with the idea that antipsychotics harm the mental process, research has

proven that antipsychotics enhance memory in Schizophrenic patients who have gained cognitive

deficits from the disorder. In a 2007 study, a randomized clinical trial used neurocognitive tests

to measure cognitive functions in Schizophrenic patients. The group who received antipsychotics

displayed an increase in memory preservation in comparison to the placebo group (Goldberg).

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Data here weakens the opposing testimonies who claim that memory impairments in

Schizophrenic people are due to the use of antipsychotics. In a similar trial in 2006, the

International Journal of Neuropsychopharmacology evaluated the cognitive effects of

antipsychotics with Schizophrenic patients. Unsurprisingly, the medicated group retained more

information in terms of semantic memory, better known as long term memory (Sumiyoshi, C.).

Two years later, Sumiyoshi stated that atypical, or newer, antipsychotics can be “associated with

improvement in various types of cognitive functions in patients with schizophrenia” with a

significant growth in memory (Sumiyoshi, C.) Antipsychotics aid in the functioning process of

cognitive skills with a significant focus on memory preservation in Schizophrenic patients.

Other noteworthy advantages of antipsychotics include significant improvements in

verbal fluency and perceptual/attentional processes in those who are medicated. These are the

abilities to analyze information as well as use senses to make inferences. In a 2007 medical

article, it stated that conventional antipsychotics improved attentional and perceptual processes

in Schizophrenics (Goldberg). Their advancements in focusing skills and perception of daily

events were due to the assistance of antipsychotics. In another study in 2003, psychologists held

a randomized clinical trial with Schizophrenic patients and tested cognitive functions to discover

that over half of the patients improved their attention span (Goldberg, TE). The substantial

differences between the non-medicated and medicated groups further advance the claim. Aiding

this data, Dr. Natanya Civjan’s book published in 2012, “Chemical Biology: Approaches to Drug

Discovery and Development to Targeting Disease” states that newer atypical antipsychotics

“have shown superior efficacy” in improving verbal fluency and other cognitive functions.

Antipsychotics repair cognitive skills including verbal fluency, perceptual focus and attention

span.
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While some psychologists advocate for the discontinuation of antipsychotics, damage can

only occur through non-compliance of the patient and the benefits outweigh the risks of not

receiving medication. Despite the dangerous side effects of discontinuing antipsychotics, medical

experts argue that prolonged use of antipsychotics is detrimental to Schizophrenic patients. For

example, in the 2011 Iowa Longitudinal Study, Schizophrenic patients participated in

neuroimaging over a three year time span to measure brain volume. The conductors of the study

claim there is a direct link from antipsychotics to brain shrinkage (Ho). In another case, John

Muench, MD, testified that antipsychotics have an association with health problems like

“increased likelihood of sedation, sexual dysfunction, postural hypotension, cardiac arrhythmia,

and sudden cardiac death” (Muench). This is a rather bold testimony considering it was not

paired with trials for support. Along with these negative side effects, in 2015, Scientific

American states that fifty-five percent of people prescribed to atypical antipsychotics experience

weight gain as a side effect of the drug as well (Alfano). Although, this could simply be a result

of dietary changes or a plethora of other personal factors. In more severe matters, Peter Breggin,

MD, believe that side effects can even include a “twenty year shortened life-span” (Breggin).

The extended use of antipsychotics is believed by some medical experts to be detrimental to the

health of Schizophrenic patients.

While antipsychotics do not induce the severe damage that some experts claim, harmful

effects can occur when Schizophrenic patients become non-adherent to their medication. In a

2017 study by The American Journal of Psychiatry, experts examined the long-term effects that

antipsychotics have on Schizophrenic patients. Data shows that these drugs do not have negative

long-term effects. In fact, the sooner a patient receives the drug, the better their remediation will

be (Goff). In other words, the longer a medication is refuted, the more time recovery will take. In
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2012, BMC Psychiatry reviewed a nationwide survey of Schizophrenia patients that assessed

side effects from antipsychotics and the majority of patients reported negative symptoms.

Although, these were all linked to a lack of adherence to the drug (Dibonaventura). The chart

attached depicts the reasons why people do not fulfill their medicinal obligations (see Appendix

1). Nearly half of the patients forgot to take their medication, while two quarters of patients did

not because they were feeling better or worse, both being improper decisions made on patient

terms. These symptoms typically only occur when patients like these abruptly discontinue their

medication regimen. There was also a correlation found between patients not complying with

their prescribed antipsychotics and higher risks of hospitalization (Haddad). Therefore, patients

are more likely to relapse if they stop medication or postpone treatment. Non-adherence to

antipsychotics can cause severe health defects and even result in a prolonged recovery.

The benefits that antipsychotics deliver to Schizophrenic people outweigh the risks of

abstaining from drug treatment. For example, in 2015, a medical video about Schizophrenia

stated that patients receiving antipsychotics have a twenty percent chance of relapse, while those

who refuse medication have a seventy-five percent chance of relapse (Khan Academy Medicine).

With this prodigious fifty-five percent difference between patients relapsing on or off

medication, antipsychotics can be deemed as the safer route. With this being said, a 2017 Science

Daily article states that neuroimaging provides enough evidence to conclude that the “majority of

patients with schizophrenia benefit from antipsychotic treatment” (Columbia University Medical

Center). In 2016, Robert Pies, MD, states “There is no convincing evidence that maintenance

treatment causes worsening of schizophrenia or related psychotic illnesses, or leads to poorer

outcomes, when compared with discontinuation of the antipsychotic” (Pies). While Pies

acknowledges that there are studies that try to disprove this claim, he discredits these attempts by
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noting the discontinuation or lack of antipsychotics causes much more severe complications than

the drug itself. Antipsychotics provide Schizophrenic patients with a variety of advantages that

make the risks of abstaining from the drug a disadvantageous option.

Schizophrenia being a disease composed of multiple disorders makes for a complex

evaluation of what treatments best suit this distinctive mental illness. The first-line treatment,

antipsychotics, vary from Atypical (newer) to Typical (older) which gives Schizophrenic patients

a broad range of treatment options. Even though there are numerous medical revelations

validating the benefits of these psychiatric drugs, some psychology experts remain advocates for

the discontinuation or lack of use of antipsychotics. Despite some medical experts judgement

toward antipsychotics and their proclaimed detrimental side effects on Schizophrenic

patients, antipsychotics are a safe and effective method of treatment to aid Schizophrenic

symptoms. Antipsychotics remain the most effective form of treatment for Schizophrenia in

comparison to the non-pharmaceutical route including therapy. Also, antipsychotics enhance

impaired cognitive deficits that derive from the disorder. Lastly, antipsychotics only cause

damage from a lack of adherence and the benefits outweigh the risks of denying medication.

Appendix
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Appendix 1. This graph demonstrates the prevalence on non-adherent behaviors

in Schizophrenia patients (DiBonaventura, appendix 1).
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Works Cited

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Balter, Michael. “Schizophrenia: Time to Flush the Meds?” Science Mag. AAAS., 5 Feb. 2014

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BBC. “Schizophrenia: talking therapy offers 'little benefit'.” BBC News. BBC. 2 Jan. 2014.

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Breggin, Peter. “Psychiatric Drugs Are More Dangerous than You Ever Imagined.” YouTube. 4

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Brooks, Megan. “Antipsychotics: No Evidence of Long-Term Harm.” Medscape. Medscape

wwwwMedical News. , 7 May 2017. Web. 25 Oct. 2017.

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Civjan, Natanya. “Chemical Biology: Approaches to Drug Discovery and Development to

wwwwTargeting Disease.” New Jersey: John Wiley and Sons, Inc., 2012. Print.

Columbia University Medical Center. “Benefits of Antipsychotics Outweighs Risks, Find

wwwwExperts.” Science Daily. Science Daily., 5 May 2017. Web. 25 Oct. 2017.

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Goldberg, Terry, and Michael Green. “Neurocognitive Functioning In Patients With

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